Implants with strong osteogenic properties are crucial for effective bone repair in clinical settings. Recently, biodegradable zinc (Zn)-based metals have shown significant potential as orthopedic implants. However, pure Zn is prone to pitting corrosion and exhibits insufficient osteogenic activity in vivo. To enhance the degradation behavior and osteogenic potential of Zn-based implants, this study developed metal-semimetal Zn-Ge alloys with varying Ge content. The addition of Ge significantly promotes the formation of eutectic Ge phases, refines the microstructure, and improves the mechanical properties of the implants. Incorporating ∼3 wt% Ge into the matrix also facilitates enhanced Zn2+ release and ensures uniform biodegradation. Besides, the formation of uniformly distributed heteroid Zn-Ge microgalvanic cells provides a balance between osteogenic and bacteriostatic effects. In vivo tests using a femoral condyle defect model demonstrate that Zn-3Ge implants have favorable osteogenic property and excellent biosafety; the enhanced osteogenic activity of the alloy is attributed to intracellular Zn2+ activation of the Wnt signaling pathway, which promotes osteoblast differentiation, cell proliferation, survival, as well as extracellular matrix mineralization and osteogenesis. The incorporation of eutectic Ge phases and effective creation of microgalvanic cells offer a promising strategy for optimizing the biological function of Zn-based implants.

Biodegradable metallic stents that dissolve over time are essential for treating vascular artery disease. Previous designs made from polymers and magnesium have not achieved the required mechanical properties and degradation patterns. Here, we report a novel zinc alloy that possesses a combination of high strength, good ductility, and uniform degradation behavior. The Zn-0.9Cu-0.4Mn-0.01Mg alloy is produced using melt spinning (a rapid solidification technique), compaction, and extrusion to enhance the synergy between strength and ductility. The melt-spun extruded alloy exhibits an elongation to failure of nearly 30% and a tensile strength exceeding 320 MPa, meeting the mechanical performance criteria required for vascular stenting materials. Melt spinning results in weak texture facilitating basal slip dislocations, and promoting ductility, while maintaining high strength. The microstructure of the melt-spun alloy displays a more uniform and finer microstructure as compared to the extruded alloy. The fine grain size and the uniform dispersion of secondary phases contribute to the uniform degradation behavior of the melt-spun extruded alloy, with a corrosion rate of ~ 0.6 mm/year and low corrosion current density of ~ 40 𝜇A/cm2. The findings suggest that rapid solidification of zinc alloys through melt spinning is a promising approach for developing biodegradable medical implants of predictable degradation.

Vascular diseases, including atherosclerosis and thrombosis, are leading causes of morbidity and mortality worldwide, often resulting in vessel stenosis that impairs blood flow and leads to severe clinical outcomes. Traditional mechanical interventions, such as balloon angioplasty and bare-metal stents, provided initial solutions but were limited by restenosis and thrombosis. The advent of drug-eluting stents improved short-term outcomes by inhibiting vascular smooth muscle cell proliferation, however, they faced challenges including delayed reendothelialization and late-stage thrombosis.

This review highlights the progression from mechanical to biological interventions in treating vascular stenosis and underscores the need for integrated approaches that combine mechanical precision with regenerative therapies.

To address long-term complications, bioresorbable stents were developed to provide temporary scaffolding that gradually dissolves, yet they still encounter challenges with mechanical integrity and optimal degradation rates. Consequently, emerging therapies now focus on biological approaches, such as gene therapy, extracellular vesicle treatments, and cell therapies, that aim to promote vascular repair at the cellular level. These strategies offer the potential for true vascular regeneration by enhancing endothelialization, modulating immune responses, and stimulating angiogenesis.

Integrating mechanical precision with regenerative biological therapies offers a promising future for treating vascular stenosis. A comprehensive approach combining these modalities could achieve sustainable vascular health.

In the field of degradable metals, Zn-based implants have gradually gained more attention. However, the relatively slow degradation rate compared with the healing rate of the damaged bone tissue, along with the excessive Zn2+ release during the degradation process, limit the application of Zn-based implants. The use of intermetallic compounds with more negative electrode potentials as sacrificial anodes of Zn-based implants is likely to be a feasible approach to resolve this contradiction. In this work, three intermetallic compounds, MgZn2, CaZn13, and Ca2Mg6Zn3, were prepared. The phase structures, microstructures, and relevant properties, such as thermal stability, in vitro degradation properties, and cytotoxicity of the compounds, were investigated. The XRD patterns indicate that the MgZn2 and CaZn13 specimens contain single-phase MgZn2 and CaZn13, respectively, while the Ca2Mg6Zn3 specimen contains Mg2Ca and Ca2Mg6Zn3 phases. After purifying treatment in 0.9% NaCl solution, high purity Ca2Mg6Zn3 phase was obtained. Thermal stability tests suggest that the MgZn2 and CaZn13 specimens possess good thermal stability below 773 K. However, the Ca2Mg6Zn3 specimen melted at around 739.1 K. Polarization curve tests show that the corrosion potentials of MgZn2, CaZn13, and Ca2Mg6Zn3 in simulated body fluid (SBF) were -1.063 VSCE, -1.289 VSCE, and -1.432 VSCE, which were all more negative than that of the pure Zn specimen (-1.003 VSCE). Clearly, these compounds can act as sacrificial anodes in Zn-based implants. The immersion tests indicate that these compounds were degraded according to the atomic ratio of the elements in each compound. Besides that, the compounds can efficiently induce Ca-P deposition in SBF. Cytotoxicity tests demonstrate that the 10% extracts prepared from these compounds exhibit good cell activity on MC3T3-E1 cells.

Compared to traditional pure zinc stents, the novel galvanized vascular stent (GVS) combines the mechanical advantages of cobalt-chromium alloy with the biological functions of zinc. This study aims to evaluate the safety and biocompatibility of the GVS in a rabbit atherosclerosis model.

A rabbit atherosclerosis model was established using a high-fat diet (HFD), and a galvanized cobalt-chromium alloy stent was implanted in the abdominal aorta. The experimental animals were followed up at 1, 3, and 6 months postsurgery. Safety was assessed through hematological parameters and histopathological analysis, and scanning electron microscopy and tissue section staining were used to evaluate re-endothelialization and intimal hyperplasia in the stented arterial segment. Proteomics was employed to uncover potential molecular mechanisms.

At each time point following GVS implantation, no significant abnormalities were observed in hematological parameters or histopathological examination of major organs. No significant restenosis was observed in the stented segment at 6 months postimplantation. A complete endothelial layer was formed on the stent surface at 1 month postsurgery, and the stent remained fully covered at 6 months. The intimal thickness adjacent to the stent struts gradually increased postsurgery but showed no significant pathological hyperplasia. Proteomics suggests that the GVS may promote vascular repair through signaling pathways, such as phosphatidylinositol 3-kinase-protein kinase B, cyclic guanosine monophosphate-protein kinase G, and cyclic adenosine monophosphate, and may have potential advantages in inducing macrophage polarization to the anti-inflammatory M2 type and inhibiting oxidative stress responses.

The GVS demonstrates good safety and biocompatibility in a rabbit atherosclerosis model.

Additively manufactured (AM) biodegradable zinc alloys hold huge potential as promising candidates for bone defect and fracture repair, thanks to their suitable biodegradation rates and acceptable biocompatibility. However, the mechanical properties of AM zinc alloys developed so far, ductility in particular, fall short of the requirements for bone substitution. Here, we present Zn-1Mn and Zn-1Mn-0.4Mg alloy implants with unique microstructures, fabricated using laser powder bed fusion (LPBF). Notably, the LPBF Zn-Mn-Mg alloy exhibited an extraordinary balance of strength and ductility, with an ultimate tensile strength of 289 MPa, yield strength of 213.5 MPa, and elongation over 20 %, outperforming all previously reported AM zinc alloys. The simultaneously enhanced strength and ductility of the ternary alloy were attributed to the strong grain-refining effect of the Mg2Zn11 second phase and the synthetic strengthening caused by the dispersion of the MnZn13 and Mg2Zn11 second phases inside the grains and at the grain boundaries. In addition, both alloys had similar rates of in vitro biodegradation (∼0.15 mm/year), properly aligned with the bone remodeling process, while also demonstrating favorable biocompatibility and upregulating multiple osteogenic markers. The Zn-Mn-Mg alloy showed even better osteogenic potential than the Zn-Mn alloy, owing to the addition of Mg. The combined attributes of the LPBF Zn-Mn-Mg ternary alloy indicated huge potential for its use as a bone repair material, especially for load-bearing bone fixation. STATEMENT OF SIGNIFICANCE: The mechanical properties of previously developed additively manufactured biodegradable zinc alloys, especially ductility, have not met the requirements for bone repair. Using laser powder bed fusion (LPBF), we fabricated Zn-1Mn and Zn-1Mn-0.4Mg alloy implants with unique microstructures. The LPBF Zn-Mn-Mg alloy demonstrated an exceptional balance of strength and ductility, achieving a tensile strength of 289 MPa, yield strength of 213.5 MPa, and elongation over 20 %, surpassing all reported AM zinc alloys. This study is the first to produce a directly printed biodegradable alloy meeting the mechanical requirements for bone fixation devices without post-processing. Additionally, the alloy exhibited moderate a biodegradation rate and excellent biocompatibility, underscoring its potential for load-bearing bone repair applications.

Zinc-based alloys have attracted increasing attention as biodegradable metals by virtue of their excellent mechanical, degradable and biocompatible properties. By introducing different levels of manganese (0.1, 0.3, 0.5 and 0.8 wt%), the properties of pure zinc were improved. The obtained zinc-manganese alloys consisted mainly of a zinc matrix and a MnZn13 phase, which led to a significant improvement of the mechanical properties with ultimate tensile strength (UTS), yield strength (YS) and elongation up to 117.3 MPa, 110.4 MPa, and 14%, respectively, and a Vickers hardness of 78 HV. After immersion in simulated body fluid (SBF), the addition of manganese slightly slowed down the corrosion rate of pure zinc, with an average corrosion rate of approximately 0.12 mm/y. Subsequent electrochemical tests and scanning Kelvin probe tests further confirmed this observation. In addition, the zinc-manganese alloys showed better resistance to E. coli and Staphylococcus aureus than pure zinc according to antimicrobial and in vitro cytotoxicity tests. Cell viability in the alloy extraction solution was higher than that of pure zinc and remained within acceptable limits (> 75%). In summary, Zn-Mn alloy has excellent performance, the promoting effect of Mn element on osteogenesis, and the excellent mechanical properties of the alloy itself, making it a potential biodegradable material for orthopedics.

In this study, biodegradable Zn-Cu-Mn alloy stents were implanted into porcine coronary artery for 18 months, and the in vivo biosafety and efficacy as well as the degradation behavior were systematically studied. Results showed a rapid endothelialization of the target vessel was achieved at 1 month post-implantation. Although the lumen diameter loss and local inflammation were observed at the early stage, the stented blood vessel could gradually recover with time. The lumen diameter was already close to normal range at 12 months, indicating good bioefficacy of the stent. No adverse effect on blood indexes or local accumulation of Zn, Cu or Mn elements were found after implantation, neither the malapposition and thrombosis were observed, which exhibited good biosafety of the stents. The stent could maintain the basic structure and mechanical integrity at 6 months, and remained only approximately 26 % of the stent volume at 18 months, suggesting a desirable degradation rate. In general, the Zn-Cu-Mn alloy stent showed great advantages and prospects in clinical application.

Biodegradable metals based on zinc are being developed to serve as temporary arterial scaffolding. Although the inclusion of copper is becoming more prevalent for grain refinement in zinc alloys, the biological activity of the copper component has not been well investigated. Here, two ZnCu alloys (0.8 and 1.5 wt% Cu) with and without thermal treatment were investigated for their hemocompatibility and biocompatibility. The microstructure was examined using scanning electron microscopy and X-ray diffraction. Zn-1.5Cu was found to contain nearly double the amount of second phase (CuZn5) precipitates as compared to Zn-0.8Cu. Thermal treatment dissolved a portion of the precipitates into the matrix. Since copper is a well-known catalyst for NO generation, the metals were tested both for their ability to generate NO release and for their thrombogenicity. Cellular responses and in vivo corrosion were characterized by a 6 months in vivo implantation of metal wires into rat arteries. The as-received Zn-1.5Cu displayed the least neointimal growth and smooth muscle cell presence, although inflammation was slightly increased. Thermal treatment was found to worsen the biological response, as determined by an increased neointimal size, increased smooth muscle cell presence and small regions of necrotic tissue. There were no trends in NO release between the alloys and thermal treatments. Corrosion progressed predominately through a pitting mechanism in vivo, which was more pronounced for the thermally treated alloys, with a more uniform corrosion seen for as-received Zn-1.5Cu. Differences in biological response are speculated to be due to changes in microstructure and pitting corrosion behavior.

Percutaneous coronary intervention is a critical treatment for coronary artery disease, particularly myocardial infarction, and is highly recommended in clinical guidelines. Traditional metallic stents, although initially effective, remain permanently in the artery and can lead to complications such as in-stent restenosis, late thrombosis, and chronic inflammation. Given the temporary need for stenting and the potential for late complications, bioresorbable stents have emerged as a promising alternative. However, bioresorbable polymeric stents have encountered significant clinical challenges due to their low mechanical strength and ductility, which increase the risks of thrombosis and local inflammation. Consequently, bioresorbable metals are being considered as a superior option for coronary stents. This review examines the progress of bioresorbable metallic stents from both preclinical and clinical perspectives, aiming to provide a theoretical foundation for future research. Iron, zinc, and magnesium are the primary materials used for these stents. Zinc-based bioresorbable stents have shown promise in preclinical studies due to their biocompatibility and vascular protective properties, although human clinical studies are still limited. Magnesium-based stents have demonstrated positive clinical outcomes, being fully absorbed within 12 months and showing low rates of late lumen loss and target lesion failure at 6- and 12-months post-implantation. Initial trials of iron-based stents have indicated favorable mid-term safety and efficacy, with complete absorption by the body within three years and consistent luminal expansion beyond six months post-implantation. Despite these advancements, further trials are needed for comprehensive validation. In conclusion, while current materials do not fully meet the ideal requirements, ongoing research should focus on developing bioresorbable stents with enhanced performance characteristics to better meet clinical needs.

Symbiotic bioabsorbable devices are ideal for temporary treatment. This eliminates the boundaries between the device and organism and develops a symbiotic relationship by degrading nutrients that directly enter the cells, tissues, and body to avoid the hazards of device retention. Symbiotic bioresorbable electronics show great promise for sensing, diagnostics, therapy, and rehabilitation, as underpinned by innovations in materials, devices, and systems. This review focuses on recent advances in bioabsorbable devices. Innovation is focused on the material, device, and system levels. Significant advances in biomedical applications are reviewed, including integrated diagnostics, tissue repair, cardiac pacing, and neurostimulation. In addition to the material, device, and system issues, the challenges and trends in symbiotic bioresorbable electronics are discussed.

Implementation of machine learning (ML) techniques in materials science often requires large data sets. However, a proper choice of features and regression methods allows the construction of accurate ML models able to work with a relatively small data set. In this work, an extensive, although still limited, experimental data set of corrosion-related properties of Zn-based alloys used in biomedicine was created. On the basis of this data set, a robust and accurate model was built to predict the corrosion behavior of Zn-based alloys. This work highlights the effectiveness of ML methods for assessing the corrosion behavior of Zn-based alloys, which can facilitate their application in bioimplants.

Biodegradable intravascular stents offer a promising alternative to permanent stents for treating atherosclerosis-related artery narrowing by potentially avoiding long-term complications. Identifying materials that degrade harmlessly and uniformly at a suitable rate is crucial. This study evaluated an advanced zinc alloy (Zn-Ag-Cu-Mn-Zr) alongside pure iron and pure zinc, using a simplified stent model of metallic wires implanted in the rat aorta. Assessments were made at 7, 24, and 84 days post-implantation using X-ray microfocus computed tomography (microCT) and contrast-enhanced microCT (CECT). For CECT, a contrast agent was chosen to provide optimal soft tissue contrast and minimal interaction with the wires. This combination of imaging techniques allowed us to evaluate degradation behavior, compare volume loss in various locations (outside the arterial lumen, inside the lumen, and encapsulated by neointima), compute degradation rates, and evaluate neointima tissue formation. Results showed that zinc and its alloy degrade less uniformly than iron, which demonstrates uniform surface degradation. The zinc alloy had a higher initial volume loss than the other materials but showed little increase over time. Neointima formation was similar for zinc and the zinc alloy, while iron provoked less tissue formation than both zinc and the reference cobalt-chromium alloy. Additionally, unlike cobalt-chromium and zinc, iron wires did not achieve consistent tissue encapsulation along their entire length, which may impair their performance. Mild inflammation was noted around zinc-based implants. Combining microCT and CECT provided 3D information on degradation uniformity, degradation products, and neointima morphometrics, highlighting the power of these imaging techniques to evaluate implant materials in a highly accurate way compared to previous 2D methods. STATEMENT OF SIGNIFICANCE: Biodegradable intravascular stents offer a promising solution to long-term complications associated with permanent stents by gradually dissolving in the body. To evaluate a novel zinc alloy (Zn-Ag-Cu-Mn-Zr) with improved mechanical properties, microstructure, and biocompatibility, we compared it to pure iron and zinc. We used advanced 3D imaging techniques, i.e., microCT and contrast-enhanced microCT, to assess the degradation behavior and the tissue response in a rat aorta model. The zinc alloy demonstrated promising properties despite less uniform degradation and mild inflammation compared to iron. Our findings highlight the superiority of 3D imaging over previously used 2D techniques in evaluating stent materials, offering critical insights into degradation processes and biocompatibility. These highly accurate measurements provide crucial information for developing improved biodegradable implants.

Mechanical properties and integrity of biodegradable Zn alloys during degradation holds significant importance. In this study, a Zn-Mg-Mn alloy with tensile strength of 414 MPa and an elongation of 26% was developed. The strength contributions of as-extruded Zn alloy from grain boundary strengthening, precipitation strengthening, and second phase strengthening. Degradation of the Zn alloy in Hank's solution exhibited a decreasing trend with prolonged immersion, eventually stabilizing at 16 μm/year. Corrosion morphology analysis revealed that the corrosion modes transformed from pitting corrosion to severely localized corrosion with prolonged immersion time, eventually lead to formation of large holes. Although the tensile strength of the Zn alloys remained relatively unchanged following varied immersion time, a substantial decrease in elongation was observed. The decreased elongation primarily attributed to the formation of surface corrosion pits or holes, exacerbating crack propagation during tension. Biocompatibility assessments of Zn alloys demonstrated that a 50% concentration of Zn alloy leach solution cultured with C3H10 and RMSC cells yielded cellular activity exceeding 80%, indicating excellent cytocompatibility. Alkaline phosphatase (ALP) and alizarin red staining results further underscored the remarkable early and late osteogenic properties exhibited by Zn-Mg-Mn alloy.

This review explores the advancements in additive manufacturing (AM) of biodegradable iron (Fe) and zinc (Zn) alloys, focusing on their potential for medical implants, particularly in vascular and bone applications. Fe alloys are noted for their superior mechanical properties and biocompatibility but exhibit a slow corrosion rate, limiting their biodegradability. Strategies such as alloying with manganese (Mn) and optimizing microstructure via laser powder bed fusion (LPBF) have been employed to increase Fe's corrosion rate and mechanical performance. Zn alloys, characterized by moderate biodegradation rates and biocompatible corrosion products, address the limitations of Fe, though their mechanical properties require improvement through alloying and microstructural refinement. LPBF has enabled the fabrication of dense and porous structures for both materials, with energy density optimization playing a critical role in achieving defect-free parts. Fe alloys exhibit higher strength and hardness, while Zn alloys offer better corrosion control and biocompatibility. In vitro and in vivo studies demonstrate promising outcomes for both materials, with Fe alloys excelling in load-bearing applications and Zn alloys in controlled degradation and vascular applications. Despite these advancements, challenges such as localized corrosion, cytotoxicity, and long-term performance require further investigation to fully harness the potential of AM-fabricated Fe and Zn biodegradable implants.

Reasonable optimization of degradation rate, antibacterial performance and biocompatibility is crucial for the development of biodegradable zinc alloy medical implant devices with antibacterial properties. In this study, various amounts of Mg elements were incorporated into Zn5Cu alloy to modulate the degradation rate, antibacterial properties and biocompatibility. The effects of Mg contents on the microstructure, corrosion behavior, antibacterial properties and biocompatibility of Zn-5Cu-xMg alloy were extensively investigated. The results revealed that with an increase of Mg content, the amount of Mg2Zn11 phase increased and its galvanic effect with the Zn matrix was enhanced, which accelerated the corrosion process and led to higher corrosion rate and high degradation rate of the alloy. Additionally, there was an increased release of Mg2+ and Zn2+ ions from the alloy which imparted excellent resistance against Escherichia coli and Staphylococcus aureus bacteria and improved biocompatibility, subcutaneous antibacterial and immune microenvironment regulation properties. Zn-5Cu-2 Mg exhibited superior antibacterial ability, cell compatibility, proliferation effect, subcutaneous antibacterial and immune microenvironment regulation performances, which can work as a promising candidate of biodegradable antibacterial medical implants.

A common problem for Zn alloys is the trade-off between antibacterial ability and biocompatibility. This paper proposes a strategy to solve this problem by increasing release ratio of Ca2+ ions, which is realized by significant refinement of CaZn13 particles through bottom circulating water-cooled casting (BCWC) and rolling. Compared with conventionally fabricated Zn-0.3Ca alloy, the BCWC-rolled alloy shows higher antibacterial abilities against E. coli and S. aureus, meanwhile much less toxicity to MC3T3-E1 cells. Additionally, plasticity, degradation uniformity, and ability to induce osteogenic differentiation in vitro of the alloy are improved. The elongation up to 49 %, which is the highest among Zn alloys with Ca, and is achieved since the sizes of CaZn13 particles and Zn grains are small and close. As a result, the long-standing problem of low formability of Zn alloys containing Ca has also been solved due to the elimination of large CaZn13 particles. The BCWC-rolled alloy is a promising candidate of making GBR membrane.

Palliative therapy utilizing interventional stents, such as vascular stents, biliary stents, esophageal stents, and other stents, has been a prevalent clinical strategy for treating duct narrowing and partial blockage. However, stent restenosis after implantation usually significantly compromises therapeutic efficacy and patient safety. Clinically, vascular stent restenosis is primarily attributed to endothelial hyperplasia and coagulation, while the risk of biliary stent occlusion is heightened by bacterial adhesion and bile sludge accumulation. Similarly, granulation tissue hyperplasia leads to tracheal stent restenosis. To address these issues, surface modifications of stents are extensively adopted as effective strategies to reduce the probability of restenosis and extend their functional lifespan. Applying coatings is one of the technical routes involving a complex selection of materials, drug loading capacities, release rates, and other factors. This paper provides an extensive overview of state of the art drug-coated stents, addressing both challenges and future prospects in this domain. We aim to contribute positively to the ongoing development and potential clinical applications of drug-coated stents in interventional therapy.

Zinc (Zn)-based biodegradable metals (BMs) fabricated through conventional manufacturing methods exhibit adequate mechanical strength, moderate degradation behavior, acceptable biocompatibility, and bioactive functions. Consequently, they are recognized as a new generation of bioactive metals and show promise in several applications. However, conventional manufacturing processes face formidable limitations for the fabrication of customized implants, such as porous scaffolds for tissue engineering, which are future direction towards precise medicine. As a metal additive manufacturing technology, laser powder bed fusion (L-PBF) has the advantages of design freedom and formation precision by using fine powder particles to reliably fabricate metallic implants with customized structures according to patient-specific needs. The combination of Zn-based BMs and L-PBF has become a prominent research focus in the fields of biomaterials as well as biofabrication. Substantial progresses have been made in this interdisciplinary field recently. This work reviewed the current research status of Zn-based BMs manufactured by L-PBF, covering critical issues including powder particles, structure design, processing optimization, chemical compositions, surface modification, microstructure, mechanical properties, degradation behaviors, biocompatibility, and bioactive functions, and meanwhile clarified the influence mechanism of powder particle composition, structure design, and surface modification on the biodegradable performance of L-PBF Zn-based BM implants. Eventually, it was closed with the future perspectives of L-PBF of Zn-based BMs, putting forward based on state-of-the-art development and practical clinical needs.

It is difficult to achieve fast kinetics of Zn2+(H2O)6 desolvation as well as HER inertia at the same electrolyte/Zn interface during long-term cycling of Zn plating/stripping in aqueous Zn-ion batteries. Herein, an effective interface construction strategy with hydrophilic transition metal oxides was proposed to achieve that balance using a CeO2 layer coating. The hydrophilic CeO2 layer can bring a balance between improving the access to the anode surface for Zn2+(H2O)6 electrolyte ions, providing uniform Zn2+ nucleation sites and HER inertia. What's more, Zn corrosion can be significantly inhibited benefiting from this coating layer. The efficiency of aqueous Zn-ion batteries showed a great enhancement. Ultra-long plating/stripping stability up to 1600 h and excellent recovery (returning to 0.5 from 20 mA cm-2) for the symmetric CeO2@Zn system were observed. A full cell with the MnO2 cathode (CeO2@Zn//MnO2) with good reversibility and stability (∼600 cycles) was fabricated for practical application. Our work provides a fundamental understanding and an essential solution to deal with the balance between rapid desolvation and inhibition of the hydrogen evolution reaction, which is important for promoting the practical application of rechargeable Zn batteries.

Zinc-based alloys, specifically Zn-Mg, have garnered considerable attention as promising materials for biodegradable implants due to their favorable mechanical strength, appropriate corrosion rate, and biocompatibility. Nevertheless, the alloy's lack of mechanical stability and integrity, resulting from ductility loss induced by age hardening at room temperature, hampers its practical bioapplication. In this study, ceramic nanoparticles have been successfully incorporated into the Zn-Mg alloy system, leading to a significant improvement in long-term stability as well as mechanical strength and ductility. In addition, this study represents the first investigation of Zn-based nanocomposites both in vitro and in vivo to comprehend the influence of nanoparticles on the degradation behavior and biocompatibility of the Zn system. The findings indicate that the incorporation of WC nanoparticles effectively refines and stabilizes the degradation behavior of Zn-Mg without negatively impacting the cytocompatibility of the alloy. The subcutaneous implantation and femoral implantation further prove the benefits of nanoparticle incorporation and found no negative effects. Collectively, Zn-Mg-WC nanocomposites yield great potential for implant usage.

Atherosclerotic cardiovascular disease (ACD) is the leading cause of death worldwide. The gold standard of treatment is the implantation of a permanent stent implant that is often associated with complications such as thrombus formation, vascular neointimal response, and stent fracture, which altogether decrease the long-term safety and efficacy of the stent. Biodegradable metallic materials have become an attractive alternative because of the ability to facilitate a more physiological healing response while the metal degrades. Recently, Molybdenum (Mo) has been considered as a potential candidate due to its excellent mechanical and medical imaging properties. Moreover, the biomedical research studies performed to date have shown minimal adverse effects in vitro and in vivo. However, there are still concerns of toxicity at high doses, and the impact of the biochemical mechanisms of Mo on material performance especially in pathophysiological environments are yet to be explored. Mo is an essential co factor for enzymes such as xanthine oxidoreductase (XOR) that plays a critical role in vascular homeostasis and ACD progression. Herein, this review will focus on the biochemistry of Mo, its physiological and pathological effects with an emphasis on cardiovascular disease as well as the recent studies on Mo for cardiovascular applications and its advantages over other biodegradable metals. The limitations of Mo research studies will also be discussed and concluded with an outlook to move this revolutionary metallic biomaterial from the bench to the bedside.

The placement of ureteral stents plays a crucial role in the treatment of ureteral strictures, therefore requiring high material performance standards. In addition, depending on the etiology of ureteral strictures, there are significant differences in the retention time of ureteral stents, thus requiring different degradation rates for the stents. Therefore, it is crucial to develop stent materials with high performance and controllable degradation rates. This study explores the potential of Zn-2Cu-0.5Fe-xMn alloy as a ureteral stent material, utilizing the antibacterial effect of copper ions, the strengthening effect of Fe element on Zn-based alloys, and the accelerated degradation effect of Mn element. The research found that with the increase in Mn content, the average grain size of the alloy and the size of (Fe, Mn)Zn13 phase gradually increased, leading to a decrease in hardness. The corrosion rate of the alloy increased with the increase in Mn content, attributed to changes in grain size and standard electrode potential differences between elements. Due to the antibacterial effects of Zn ions and Cu ions, the Zn-2Cu-0.5Fe-xMn alloy exhibits good anti-stone formation capabilities. Furthermore, the alloy also demonstrates acceptable cytotoxicity. Therefore, the Zn-2Cu-0.5Fe-xMn alloy is expected to become an important implant material in urological surgery.

Biodegradable zinc (Zn) alloys stand out as promising contenders for biomedical applications due to their favorable mechanical properties and appropriate degradation rates, offering the potential to mitigate the risks and expenses associated with secondary surgeries. While current research predominantly centers on the in vitro examination of Zn alloys, notable disparities often emerge between in vivo and in vitro findings. Consequently, conducting in vivo investigations on Zn alloys holds paramount significance in advancing their clinical application. Different element compositions and processing methods decide the mechanical properties and biological performance of Zn alloys, thus affecting their suitability for specific medical applications. This paper presents a comprehensive overview of recent strides in the development of biodegradable Zn alloys, with a focus on key aspects such as mechanical properties, toxicity, animal experiments, biological properties, and molecular mechanisms. By summarizing these advancements, the paper aims to broaden the scope of research directions and enhance the understanding of the clinical applications of biodegradable Zn alloys.

Zinc, along with magnesium and iron, is considered one of the most promising biodegradable metals. Compared with magnesium and iron, pure Zn exhibits poor mechanical properties, despite its mild biological corrosion behavior and beneficial biocompatibility. Laser powder bed fusion (LPBF), unlike traditional manufacturing techniques, has the capability to rapidly manufacture near-net-shape components. At present, although the combination of LPBF and Zn has made great progress, it is still in its infancy. Element loss and porosity are common processing problems for LPBF Zn, mainly due to evaporation during melting under a high-energy beam. The formation quality and properties of the final material are closely related to the alloy composition, design and processing. This work reviews the state of research and future perspective on LPBF zinc from comprehensive assessments such as powder characteristics, alloy composition, processing, formation quality, microstructure, and properties. The effects of powder characteristics, process parameters and evaporation on formation quality are introduced. The mechanical, corrosion, and biocompatibility properties of LPBF Zn and their test methodologies are introduced. The effects of microstructure on mechanical properties and corrosion properties are analyzed in detail. The practical medical application of Zn is introduced. Finally, current research status is summarized together with suggested directions for advancing knowledge about LPBF Zn.

Osteochondral defect is a complex tissue loss disease caused by arthritis, high-energy trauma, and many other reasons. Due to the unique structural characteristics of osteochondral tissue, the repair process is sophisticated and involves the regeneration of both hyaline cartilage and subchondral bone. However, the current clinical treatments often fall short of achieving the desired outcomes. Tissue engineering bioscaffolds, especially those created via three-dimensional (3D) printing, offer promising solutions for osteochondral defects due to their precisely controllable 3D structures. The microstructure of 3D-printed bioscaffolds provides an excellent physical environment for cell adhesion and proliferation, as well as nutrient transport. Traditional 3D-printed bioscaffolds offer mere physical stimulation, while drug-loaded 3D bioscaffolds accelerate the tissue repair process by synergistically combining drug therapy with physical stimulation. In this review, the physiological characteristics of osteochondral tissue and current treatments of osteochondral defect were reviewed. Subsequently, the latest progress in drug-loaded bioscaffolds was discussed and highlighted in terms of classification, characteristics, and applications. The perspectives of scaffold design, drug control release, and biosafety were also discussed. We hope this article will serve as a valuable reference for the design and development of osteochondral regenerative bioscaffolds and pave the way for the use of drug-loaded bioscaffolds in clinical therapy.

In vitro testing for evaluating degradation mode and rate of candidate biodegradable metals to be used as intravascular stents is crucial before going to in vivo animal models. In this study, we show that X-ray microfocus computed tomography (microCT) presents a key added value to visualize degradation mode and to evaluate degradation rate and material surface properties in 3D and at high resolution of large regions of interest. The in vitro degradation behavior of three candidate biodegradable stent materials was evaluated: pure iron (Fe), pure zinc (Zn), and a quinary Zn alloy (ZnAgCuMnZr). These metals were compared to a reference biostable cobaltchromium (CoCr) alloy. To compare the degradation mode and degradation rate evaluated with microCT, scanning electron microscopy (SEM) and inductively-coupled plasma (ICP) were included. We confirmed that Fe degrades very slowly but with desirable uniform surface corrosion. Zn degrades faster but exhibits localized deep pitting corrosion. The Zn alloy degrades at a similar rate as the pure Zn, but more homogeneously. However, the formation of deep internal dendrites was observed. Our study provides a detailed microCT-based comparison of essential surface and corrosion properties, with a structural characterization of the corrosion behavior, of different candidate stent materials in 3D in a non-destructive way.

Medical devices to treat arterial diseases of older humans are routinely designed and developed using young animals. This is the case despite the significant declines of tissue regeneration, cell proliferation, and inflammation in aged humans that are not reflected in young animals. The widespread use of age-mismatched animals is particularly a concern for the testing of interactive materials, such as biodegradable metals whose dynamic interfaces continuously impact local cell and tissue regenerative processes. In order to determine the importance and impact of age differences in biodegradable stent material biocompatibility, we implanted both inert (platinum) and biodegradable (zinc) metal wires into the arteries of 1 year old and 3-month-old rats for a period of 6 months and compared the biological responses. It was found that the older animals developed a significantly larger neointimal encapsulating tissue for zinc implants vs. a smaller tissue response for the platinum implants relative to the younger rats. The neointimas of older rats contained dramatically fewer macrophages for both implant metals. The presence of neointimal smooth muscle cells was also decreased in the older rats. Endothelial cell regeneration in the old arteries was not impacted by the different metal implants. These findings demonstrate that neointimal responses to metal implants in arterial tissue are strongly impacted by age-related changes. The findings also suggest that the reliance on young animal models to evaluate metal implants intended for the arteries of considerably older individuals may substantially over predict the biocompatibility.

The past five years have yielded impressive advancements in fully absorbable metal stent technology. The desired ultimate ability for such devices to treat a vascular stenosis without long-term device-related complications or impeding future treatment continues to evoke excitement in clinicians and engineers alike. Nowhere is the need for fully absorbable metal stents greater than in patients experiencing vascular anomalies associated with congenital heart disease (CHD). Perhaps not surprisingly, commercially available absorbable metal stents have been implanted in pediatric cardiology patients with conditions ranging from pulmonary artery and vein stenosis to coarctation of the aorta and conduit/shunt reconstructions. Despite frequent short term procedural success, device performance has missed the mark with the commercially available devices not achieving degradation benchmarks for given applications. In this review we first provide a general overview detailing the theory of absorbable metal stents, and then review recent clinical use in CHD patients since the release of current-generation absorbable metal stents around 2019. We also discuss the challenges and our center's experience associated with the use of absorbable metal stents in this pediatric population. Lastly, we present potential directions for future engineering endeavors to mitigate existing challenges.

The development of bioabsorbable implants from Zn alloys is one of the main interests in the new generation of biomaterials. The main drawbacks of Zn-based materials are their insufficient mechanical properties. In the presented studies, a quaternary alloy composed of zinc with magnesium (0.2-1 wt. %), calcium (0.1-0.5 wt. %) and strontium (0.05-0.5 wt. %) was prepared by gravity casting followed by hot extrusion and then by hydrostatic extrusion. Microstructural characterization using scanning electron microscopy (SEM) and X-ray diffraction (XRD) phase analysis was performed. The mechanical properties were examined, using static tensile tests. Corrosion properties were analyzed using immersion tests. Samples were immersed in Hanks' solution (temperature = 37 °C, pH = 7.4) for 14 days. All alloys were subjected after corrosion to SEM observations on the surface and cross-section. The corrosion rate was also calculated. The microstructure of the investigated quaternary alloy consists of the α-Zn grains and intermetallic phases Mg2Zn11, CaZn13 and SrZn13 with different grain sizes and distribution, which impacted both mechanical and corrosion properties. Thanks to the alloying by the addition of Mg, Ca, and Sr and plastic deformation using hydrostatic extrusion, outstanding mechanical properties were obtained along with improvement in uniformity of corrosion rate.

Biodegradable Zn alloys show great potential for vascular stents due to their moderate degradation rates and acceptable biocompatibility. However, the poor mechanical properties limit their applications. In this study, low alloyed Zn-2Cu-xLi (x = 0.004, 0.01, 0.07 wt %) alloys with favorable mechanical properties were developed. The microstructure consists of fine equiaxed η-Zn grains, micron, submicron-sized and coherent nano ε-CuZn4 phases. The introduced Li exists as a solute in the η-Zn matrix and ε-CuZn4 phase, and results in the increase of ε-CuZn4 volume fraction, the refinement of grains and more uniform distribution of grain sizes. As Li content increases, the strength of alloys is dramatically improved by grain boundary strengthening, precipitate strengthening of ε-CuZn4 and solid solution strengthening of Li. Zn-2Cu-0.07Li alloy has the optimal mechanical properties with a tensile yield strength of 321.8 MPa, ultimate tensile strength of 362.3 MPa and fracture elongation of 28.0 %, exceeding the benchmark of stents. It also has favorable mechanical property stability, weak tension compression yield asymmetry and strain rate sensitivity. It exhibits uniform degradation and a little improved degradation rate of 89.5 μm∙year-1, due to the improved electrochemical activity by increased ε-CuZn4 volume fraction, and generates Li2CO3 and LiOH. It shows favorable cytocompatibility without adverse influence on endothelial cell viability by trace Li+. The fabricated microtubes show favorable mechanical properties, and stents exhibit an average radial strength of 118 kPa. The present study indicates that Zn-2Cu-0.07Li alloy is a potential and promising candidate for vascular stent applications. STATEMENT OF SIGNIFICANCE: Zn alloys are promising candidates for biodegradable vascular stents. However, improving their mechanical properties is challenging. Combining the advantages of Cu and trace Li, Zn-2Cu-xLi (x < 0.1 wt %) alloys were developed for stents. As Li increases, the strength of alloys is dramatically improved by refined grains, increased volume fraction of ε-CuZn4 and solid solution of Li. Zn-2Cu-0.07Li alloy exhibits a TYS exceeding 320 MPa, UTS exceeding 360 MPa and fracture EL of nearly 30 %. It shows favorable mechanical stability, degradation behaviors and cytocompatibility. The alloy was fabricated into microtubes and stents for mechanical property tests to verify application feasibility for the first time. This indicates that Zn-2Cu-0.07Li alloy has great potential for vascular stent applications.

Magnesium matrix composites are essential lightweight metal matrix composites, following aluminum matrix composites, with outstanding application prospects in automotive, aerospace lightweight and biomedical materials because of their high specific strength, low density and specific stiffness, good casting performance and rich resources. However, the inherent low plasticity and poor fatigue resistance of magnesium hamper its further application to a certain extent. Many researchers have tried many strengthening methods to improve the properties of magnesium alloys, while the relationship between wear resistance and plasticity still needs to be further improved. The nanoparticles added exhibit a good strengthening effect, especially the ceramic nanoparticles. Nanoparticle-reinforced magnesium matrix composites not only exhibit a high impact toughness, but also maintain the high strength and wear resistance of ceramic materials, effectively balancing the restriction between the strength and toughness. Therefore, this work aims to provide a review of the state of the art of research on the matrix, reinforcement, design, properties and potential applications of nano-reinforced phase-reinforced magnesium matrix composites (especially ceramic nanoparticle-reinforced ones). The conventional and potential matrices for the fabrication of magnesium matrix composites are introduced. The classification and influence of ceramic reinforcements are assessed, and the factors influencing interface bonding strength between reinforcements and matrix, regulation and design, performance and application are analyzed. Finally, the scope of future research in this field is discussed.

Despite being a weaker metal, zinc has become an increasingly popular candidate for biodegradable implant applications due to its suitable corrosion rate and biocompatibility. Previous studies have experimented with various alloy elements to improve the overall mechanical performance of pure Zn without compromising the corrosion performance and biocompatibility; however, the thermal stability of biodegradable Zn alloys has not been widely studied. In this study, TiC nanoparticles were introduced for the first time to a Zn-Al-Cu system. After hot rolling, TiC nanoparticles were uniformly distributed in the Zn matrix and effectively enabled phase control during solidification. The Zn-Cu phase, which was elongated and sharp in the reference alloy, became globular in the nanocomposite. The strength of the alloy, after introducing TiC nanoparticles, increased by 31% from 259.7 to 340.3 MPa, while its ductility remained high at 49.2% elongation to failure. Fatigue performance also improved greatly by adding TiC nanoparticles, increasing the fatigue limit by 47.6% from 44.7 to 66 MPa. Furthermore, TiC nanoparticles displayed excellent phase control capability during body-temperature aging. Without TiC restriction, Zn-Cu phases evolved into dendritic morphologies, and the Al-rich eutectic grew thicker at grain boundaries. However, both Zn-Cu and Al-rich eutectic phases remained relatively unchanged in shape and size in the nanocomposite. A combination of exceptional tensile properties, improved fatigue performance, better long-term stability with a suitable corrosion rate, and excellent biocompatibility makes this new Zn-Al-Cu-TiC material a promising candidate for biodegradable stents and other biodegradable applications.

To examine the 16-year developmental history, research hotspots, and emerging trends of zinc-based biodegradable metallic materials from the perspective of structural and temporal dynamics.

The literature on zinc-based biodegradable metallic materials in WoSCC was searched. Historical characteristics, the evolution of active topics and development trends in the field of zinc-based biodegradable metallic materials were analyzed using the bibliometric tools CiteSpace and HistCite.

Over the past 16 years, the field of zinc-based biodegradable metal materials has remained in a hotspot stage, with extensive scientific collaboration. In addition, there are 45 subject categories and 51 keywords in different research periods, and 80 papers experience citation bursts. Keyword clustering anchored 3 emerging research subfields, namely, #1 plastic deformation #4 additive manufacturing #5 surface modification. The keyword alluvial map shows that the longest-lasting research concepts in the field are mechanical property, microstructure, corrosion behavior, etc., and emerging keywords are additive manufacturing, surface modification, dynamic recrystallization, etc. The most recent research on reference clustering has six subfields. Namely, #0 microstructure, #2 sem, #3 additive manufacturing, #4 laser powder bed fusion, #5 implant, and #7 Zn-1Mg.

The results of the bibliometric study provide the current status and trends of research on zinc-based biodegradable metallic materials, which can help researchers identify hot spots and explore new research directions in the field.

Reconciling the dilemma between rapid degradation and overdose toxicity is challenging in biodegradable materials when shifting from bulk to porous materials. Here, we achieve significant bone ingrowth into Zn-based porous scaffolds with 90% porosity via osteoinmunomodulation. At microscale, an alloy incorporating 0.8 wt% Li is employed to create a eutectoid lamellar structure featuring the LiZn4 and Zn phases. This microstructure optimally balances high strength with immunomodulation effects. At mesoscale, surface pattern with nanoscale roughness facilitates filopodia formation and macrophage spreading. At macroscale, the isotropic minimal surface G unit exhibits a proper degradation rate with more uniform feature compared to the anisotropic BCC unit. In vivo, the G scaffold demonstrates a heightened efficiency in promoting macrophage polarization toward an anti-inflammatory phenotype, subsequently leading to significantly elevated osteogenic markers, increased collagen deposition, and enhanced new bone formation. In vitro, transcriptomic analysis reveals the activation of JAK/STAT pathways in macrophages via up regulating the expression of Il-4, Il-10, subsequently promoting osteogenesis.

Zinc (Zn)-dysprosium (Dy) binary alloys are promising biodegradable bone fracture fixation implants owing to their attractive biodegradability and mechanical properties. However, their clinical application is a challenge for bone fracture healing, due to the lack of Zn-Dy alloys with tailored proper bio-mechanical and osteointegration properties for bone regeneration. A Zn-5Dy alloy with high strength and ductility and a degradation rate aligned with the bone remodeling cycle is developed. Here, mechanical stability is further confirmed, proving that Zn-5Dy alloy can resist aging in the degradation process, thus meeting the mechanical requirements of fracture fixation. In vitro cellular experiments reveal that the Zn-5Dy alloy enhances osteogenesis and angiogenesis by elevating SIRT4-mediated mitochondrial function. In vivo Micro-CT, SEM-EDS, and immunohistochemistry analyses further indicate good biosafety, suitable biodegradation rate, and great osteointegration of Zn-5Dy alloy during bone healing, which also depends on the upregulation of SIRT4-mediated mitochondrial events. Overall, the study is the first to report a Zn-5Dy alloy that exerts remarkable osteointegration properties and has a strong potential to promote bone healing. Furthermore, the results highlight the importance of mitochondrial modulation and shall guide the future development of mitochondria-targeting materials in enhancing bone fracture healing.

Bone fractures and critical-size bone defects are significant public health issues, and clinical treatment outcomes are closely related to the intrinsic properties of the utilized implant materials. Zinc (Zn)-based biodegradable metals (BMs) have emerged as promising bioactive materials because of their exceptional biocompatibility, appropriate mechanical properties, and controllable biodegradation. This review summarizes the state of the art in terms of Zn-based metals for bone repair and regeneration, focusing on bridging the gap between biological mechanism and required bioactivity. The molecular mechanism underlying the release of Zn ions from Zn-based BMs in the improvement of bone repair and regeneration is elucidated. By integrating clinical considerations and the specific bioactivity required for implant materials, this review summarizes the current research status of Zn-based internal fixation materials for promoting fracture healing, Zn-based scaffolds for regenerating critical-size bone defects, and Zn-based barrier membranes for reconstituting alveolar bone defects. Considering the significant progress made in the research on Zn-based BMs for potential clinical applications, the challenges and promising research directions are proposed and discussed.

Zinc (Zn) is a bioabsorbable metal that shows great potential as an implant material for orthopedic applications. Suitable concentrations of zinc ions promote osteogenesis, while excess zinc ions cause apoptosis. As a result, the conflicting impacts of Zn2+ concentration on osteogenesis could prove to be significant problems for the creation of novel materials. This study thoroughly examined the cell viability, proliferation, and osteogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs) cultured in various concentrations of Zn2+ in vitro and validated the osteogenesis effects of zinc implantation in vivo. The effective promotion of cell survival, proliferation, migration, and osteogenic differentiation of bone marrow mesenchymal stem cell (BMSCs) may be achieved at a low concentration of Zn2+ (125 μM). The excessively high concentration of zinc ions (>250 μM) not only reduces BMSCs' viability and proliferation but also causes them to suffer apoptosis due to the disturbed zinc homeostasis and excessive Zn2+. Moreover, transcriptome sequencing was used to examine the underlying mechanisms of zinc-induced osteogenic differentiation with particular attention paid to the PI3K-AKT and TGF-β pathways. The present investigation elucidated the dual impacts of Zn2+ microenvironments on the osteogenic characteristics of rBMSCs and the associated processes and might offer significant insights for refining the blueprint for zinc-based biomaterials.

Recently, zinc (Zn) and its alloys have demonstrated great potential as guided bone regeneration (GBR) membranes to treat the problems of insufficient alveolar bone volume and long-term osseointegration instability during dental implantology. However, bone regeneration is a complex process consisting of osteogenesis, angiogenesis, and antibacterial function. For now, the in vivo osteogenic performance and antibacterial activity of pure Zn are inadequate, and thus fabricating a platform to endow Zn membranes with multifunctions may be essential to address these issues. In this study, various bimetallic magnesium/copper metal-organic framework (Mg/Cu-MOF) coatings were fabricated and immobilized on pure Zn. The results indicated that the degradation rate and water stability of Mg/Cu-MOF coatings could be regulated by controlling the feeding ratio of Cu2+. As the coating and Zn substrate degraded, an alkaline microenvironment enriched with Zn2+, Mg2+, and Cu2+ was generated. It significantly improved calcium phosphate deposition, differentiation of osteoblasts, and vascularization of endothelial cells in the extracts. Among them, Mg/Cu1 showed the best comprehensive performance. The superior antibacterial activity of Mg/Cu1 was demonstrated in vitro and in vivo, which indicated significantly enhanced bacteriostatic activity against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli as compared to that of the bare sample. Bimetallic Mg/Cu-MOF coating could properly coordinate the multifunction on a Zn membrane and could be a promising platform for promoting its bone regeneration, which could pave the way for Zn-based materials to be used as barrier membranes in oral clinical trials.